Photograph by: Ian Smith
, Vancouver Sun

In my 25 years of working as executive director at Coast Mental Health Society, I have had the honour to witness so many people find the hope and courage to recover from devastating mental illnesses. I have also experienced firsthand the breadth of support that is necessary for recovery. Since its inception 40 years ago, Coast, working with other non-profit and government organizations, has been a vital part of providing British Columbians with a mental illness the tools they need to heal, regain their dignity and reestablish their lives.

Still, overcoming the barriers to treatment that those with a mental illness face has often been daunting. Mental illness is rarely a stand-alone problem. As this week marks the Canadian Centre on Substance Abuse’s National Addictions Awareness Week, it is worth noting that adults with a mental illness are more than twice as likely to have a substance abuse disorder. When mental illness and substance abuse occur together, this is known as a concurrent disorder. More often than not, the mental illness emerges first and substance abuse follows. It frequently is the beginning of a downward spiral ending in poverty and homelessness.

In Vancouver, we see the brutal result of untreated concurrent disorders on our streets everyday. According to a study published earlier this year by Dr. Michael Krausz, the UBC Providence Leadership Chair for addiction research, 93 per cent of Vancouver’s homeless have a mental disorder while 83 per cent of them have a substance abuse disorder. An article in this very publication in May highlighted that homelessness has more than doubled in Vancouver this year, with the situation set to worsen significantly by 2014 if action is not taken.

When the statistics are laid out in black and white, it becomes obvious that mental illness, substance abuse and homelessness are too closely connected to be treated independently of one another. In fact, approaching mental illness, substance abuse or homelessness as isolated problems is unlikely to bring long-term success. However, in the case of homelessness in particular, this is often the approach.

Compared with the demand, there are few places in British Columbia that are able to provide the long-term support needed to help people recover from mental illness and substance abuse. Many of those coping with mental illness and substance abuse only get access to help once they have landed in the criminal justice system or been admitted to hospital for other illnesses or even suicide attempts. Sadly, once these people have been given what can only be called triage treatment, they too often end up back on the streets with no access to followup care or the supportive framework that would enable them to manage their illness and addiction.

If Vancouver is to keep the number of people sleeping on the city’s streets from exploding, there needs to be support for new residential approaches capable of providing long-term treatment for mental illness and substance abuse under one roof. The need for such facilities was already identified in a report in June 2011 titled Centre for Excellence in Addictions and Concurrent Disorders.

The report outlines the potential for a coherent and coordinated system of care that builds on resources that already exist. The Centre would not only provide long-term support to people recovering from a complex mix of mental illness, substance abuse and other health issues, but serve as a focal point for research and professional training and development in the region. There is a huge wealth of expertise, experience and a passionate commitment to helping those recovering from concurrent disorders that already exists in our communities. The Centre for Excellence in Addictions and Concurrent Disorders would galvanize these pockets of excellence and ensure that they are able to fulfil their core mandate: helping those who need it most.

During National Addictions Awareness Week, it makes sense for non-profit organizations like Coast Mental Health Society, care providers from the medical, addictions and psychiatry community, researchers, and criminal justice professionals to turn their attention to this emerging opportunity to transform how we treat mental illness and substance abuse. Vancouver has a reputation as a North American hot spot for homelessness. By successfully tackling concurrent disorders, Vancouver can become known as a North American hot spot of compassion, knowledge and, most importantly, of recovery.

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